Acesso da pessoa com doença falciforme aos serviços de saúde: marcas do racismo estrutural

Abstract

Sickle Cell Disease comprises a group of hereditary genetic disorders most prevalent among the Black population and, in Brazil, is recognized as a public health issue due to its high incidence in states with large concentrations of people of African descent, such as Bahia. Despite institutional advances aimed at promoting equity, such as the National Policy for the Comprehensive Health of the Black Population (PNSIPN), access to health services for people with Sickle Cell Disease remains limited, shaped by historical, social, cultural, and structural factors, with racism as a central element in the production of health inequities. As a social determinant of health, racism impacts the reception, diagnosis, and treatment of affected individuals. This study aims to analyze how racism interferes with the access of people with Sickle Cell Disease to health services. It is a critical literature review based on the analysis of academic publications from 2010 to 2025, using predefined inclusion and exclusion criteria. The studies were organized into thematic axes that highlight: (1) structural racism and social inequalities that shape the health trajectory of people with Sickle Cell Disease; (2) concrete and subjective barriers that hinder access and care; and (3) invisibilities and professional unawareness about the disease and its racial dimensions. It is concluded that racism significantly interferes with the provision of care for people with Sickle Cell Disease, and recognizing it as a social determinant is essential to ensure comprehensive, equitable, and high-quality health care